[Cetoacidosis diabética al diagnóstico de diabetes mellitus tipo 1 en Asturias entre 2011 y 2020: influencia de la duración de los síntomas en la prevalencia de cetoacidosis y en la pérdida de peso.] / Diabetic ketoacidosis at diagnosis of type 1 diabetes in Asturias (Spain) between 2011 and 2020: influence of symptom duration on prevalence of ketoacidosis and weight loss.

OBJECTIVE: Diabetic ketoacidosis (DKA) is a serious complication that usually occurs at diagnosis of type 1 diabetes mellitus (T1D). However, the prevalence of DKA at diagnosis of T1D is heterogeneous in different regions of the world. The aim of this study was to determine the prevalence of DKA at diagnosis of T1D in Asturias. METHODS: This study included all patients under nineteen years of age diagnosed with T1D in Asturias between 2011 and 2020. Retrospective review of medical records was performed to analyse DKA and other characteristics at diagnosis. A log binary regression model was constructed to obtain an estimate of the prevalence ratio of DKA to diagnosis in the years studied. RESULTS: A total of 267 people were diagnosed with a mean age of 9.85±4.46 years. The prevalence of DKA at diagnosis during this period was 38.63%. There was an increasing trend, with a prevalence ratio over the years studied of 1.015 (95%CI: 0.96-1.07; p=0.61). Duration of symptoms before diagnosis was 4.57±7.64 weeks. Weight loss was 7.56±7.26%, being more than 10% of previous weight in almost half of the patients who loosed weight. There was a positive relationship between symptoms duration and prevalence of DKA and between time to diagnosis and weight loss. CONCLUSIONS: Asturias has a high prevalence of DKA at diagnosis of T1D, slightly higher than observed in other studies at national level and higher than in other similar countries, with a tendency to increase. Delayed diagnosis is a key factor in the prevalence of DKA and weight loss. Thus, health actions are needed for the early detection of T1D to avoid DKA at diagnosis.

OBJETIVO: La cetoacidosis diabética (CAD) es una complicación grave que puede producirse al diagnóstico de la diabetes mellitus tipo 1 (DM1). La prevalencia de CAD al diagnóstico de DM1 es desigual en las distintas regiones del mundo. El objetivo de este estudio fue conocer la prevalencia de CAD al diagnóstico de DM1 en Asturias. METODOS: Se incluyeron los pacientes menores de diecinueve años diagnosticados de DM1 en Asturias entre 2011 y 2020. Mediante revisión de historia clínica se analizó la prevalencia de CAD así como otras características al diagnóstico. Se construyó un modelo de regresión log binaria para obtener una estimación de la razón de prevalencia de CAD al diagnóstico en los años estudiados. RESULTADOS: Se diagnosticaron 267 personas con edad media de 9,85±4,46 años. La prevalencia de CAD al diagnóstico fue del 38,63%. Se apreció una tendencia al aumento, con una razón de prevalencia en los años estudiados de 1,015 (IC95%:0,96-1,07; p=0,61). La duración de los síntomas hasta el diagnóstico fue de 4,57±7,64 semanas. La pérdida de peso fue de 7,56±7,26%, siendo superior al 10% en casi la mitad de los pacientes que perdieron peso. Se apreció relación entre la duración de los síntomas y la prevalencia de CAD, y entre el tiempo de evolución y la pérdida de peso. CONCLUSIONES: Asturias presenta una alta prevalencia de CAD al diagnóstico de DM1, levemente superior a otros estudios a nivel nacional y superior a otros países de nuestro entorno, con tendencia al aumento. El retraso diagnóstico es clave en la prevalencia de CAD y en la pérdida de peso. Son necesarias actuaciones sanitarias para la detección precoz de la DM1.

Cetoacidosis diabética al diagnóstico de diabetes mellitus tipo 1 en Asturias entre 2011 y 2020: influencia de la duración de los síntomas en la prevalencia de cetoacidosis y en la pérdida de peso / Diabetic ketoacidosis at diagnosis of type 1 diabetes in Asturias (Spain) between 2011 and 2020: influence of symptom duration on prevalence of ketoacidosis and weight loss

Fundamentos: La cetoacidosis diabética (CAD) es una complicación grave que puede producirse al diagnóstico de la diabetes mellitus tipo 1 (DM1). La prevalencia de CAD al diagnóstico de DM1 es desigual en las distintas regiones del mundo. El objetivo de este estudio fue conocer la prevalencia de CAD al diagnóstico de DM1 en Asturias. Métodos: Se incluyeron los pacientes menores de diecinueve años diagnosticados de DM1 en Asturias entre 2011 y 2020. Mediante revisión de historia clínica se analizó la prevalencia de CAD así como otras características al diagnóstico. Se construyó un modelo de regresión logbinaria para obtener una estimación de la razón de prevalencia de CAD al diagnóstico en los años estudiados. Resultados: Se diagnosticaron 267 personas con edad media de 9,85±4,46 años. La prevalencia de CAD al diagnóstico fue del 38,63%. Se apreció una tendencia al aumento, con una razón de prevalencia en los años estudiados de 1,015 (IC95%:0,96-1,07; p=0,61). La duración de los síntomas hasta el diagnóstico fue de 4,57±7,64 semanas. La pérdida de peso fue de 7,56±7,26%, siendo superior al 10% en casi la mitad de los pacientes que perdieron peso. Se apreció relación entre la duración de los síntomas y la prevalencia de CAD, y entre el tiempo de evolución y la pérdida de peso. Conclusiones: Asturias presenta una alta prevalencia de CAD al diagnóstico de DM1, levemente superior a otros estudios a nivel nacional y superior a otros países de nuestro entorno, con tendencia al aumento. El retraso diagnóstico es clave en la prevalencia de CAD y en la pérdida de peso. Son necesarias actuaciones sanitarias para la detección precoz de la DM1.(AU)

Background: Diabetic ketoacidosis (DKA) is a serious complication that usually occurs at diagnosis of type 1 diabetes mellitus (T1D). However, the prevalence of DKA at diagnosis of T1D is heterogeneous in different regions of the world. The aim of this study was to determine the prevalence of DKA at diagnosis of T1D in Asturias. Methods: This study included all patients under nineteen years of age diagnosed with T1D in Asturias between 2011 and 2020. Retrospective review of medical records was performed to analyse DKA and other characteristics at diagnosis. A log binary regression model was constructed to obtain an estimate of the prevalence ratio of DKA to diagnosis in the years studied. Results: A total of 267 people were diagnosed with a mean age of 9.85±4.46 years. The prevalence of DKA at diagnosis during this period was 38.63%. There was an increasing trend, with a prevalence ratio over the years studied of 1.015 (95%CI: 0.96-1.07; p=0.61). Duration of symptoms before diagnosis was 4.57±7.64 weeks. Weight loss was 7.56±7.26%, being more than 10% of previous weight in almost half of the patients who loosed weight. There was a positive relationship between symptoms duration and prevalence of DKA and between time to diagnosis and weight loss. Conclusions: Asturias has a high prevalence of DKA at diagnosis of T1D, slightly higher than observed in other studies at national level and higher than in other similar countries, with a tendency to increase. Delayed diagnosis is a key factor in the prevalence of DKA and weight loss. Thus, health actions are needed for the early detection of T1D to avoid DKA at diagnosis.(AU)

Adaptation, reliability and validity of health-related quality of life questionnaires: Disabkids chronic and specific diabetes disease in children and adolescents with diabetes mellitus type 1.

INTRODUCTION: It is recommended to periodically evaluate the health-related quality of life (HRQoL) in children and adolescents with type 1 diabetes mellitus (DM1). Despite this, no specific paediatric HRQoL instrument for DM1 has been validated in Spanish. OBJECTIVES: Multicentre, prospective descriptive study in children and adolescents with DM1 with the aim of carrying out cross-cultural adaptation to Spanish and evaluating the reliability and validity of the DISABKIDS chronic disease and diabetes-specific HRQoL questionnaires, using reverse translation. MATERIAL AND METHODS: Sociodemographic variables were compiled together with the most recent capillary glycated haemoglobin (HbA1c) value and HRQoL questionnaires were handed out to 200 Spanish children and adolescents with DM1 aged between 8 and 18 years of age under evaluation in 12 different hospitals. RESULTS: The mean score on the HRQoL questionnaire (patient version) for chronic disease was 80.32 (13.66), being significantly lower (P = .04) in patients with a shorter duration of the disease (≤5 years): 78.34 (13.70) vs. 82.60 (13.36). The mean score of the DM1-specific modules was: 60.81 (16.23) for disease impact and 65.59 (26.19) for treatment impact. The mean HbA1c value was 7.08 (0.79), with no differences (P > .05) noted in the mean score of the HRQoL instruments in patients with HbA1c ≤7% vs. HbA1c >7%. The Cronbach α value varied between 0.72 and 0.90. CONCLUSIONS: The Spanish versions of the DISABKIDS HRQoL instruments meet the proposed objectives of semantic equivalence and internal consistency, making it possible to periodically assess HRQoL in these patients. The good average glycaemic control presented by the patients may explain why no difference was found in the HRQoL instruments based on the HbA1c value.

¿Aporta la realización de monitorización ambulatoria de la presión arterial frente a la toma aislada en los pacientes pediátricos con diabetes tipo 1? / Does ambulatory blood pressure monitoring contribute anything to clinic blood pressure in paediatric patients with type 1 diabetes?

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Comentarios sobre el artículo «Prevalencia y datos asistenciales de la diabetes mellitus tipo 1 en menores de 15 años en Asturias» / Comment about the article "Type 1 diabetes mellitus prevalence and care in children under 15 years old in Asturias"

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Maternal assessment of recommendations on the newborn infant care upon hospital discharge.

INTRODUCTION: It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. POPULATION AND METHODS: Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. RESULTS: A hundred and seventy-six surveys were collected. Of these, 68.8% respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3%), bottle feeding (20.0%), and umbilical cord care (11.1%). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. CONCLUSIONS: Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.

Valoración de las madres acerca de las recomendaciones para el cuidado del recién nacido al momento del alta hospitalaria / Maternal assessment of recommendations on the newborn infant care upon hospital discharge

Introducción. Es habitual que el pediatra ofrezca a los padres información sobre cuidados del neonato al momento del alta hospitalaria. Los objetivos del estudio son conocer la satisfacción respecto a dicha información, qué otras informaciones les hubiese gustado recibir y determinar qué factores pueden influir en esa demanda. Población y métodos. Estudio descriptivo que evalúa la opinión de las puérperas a los 5-15 días del parto, en cuanto a dicha información. Resultados. Se recogieron 176 encuestas. El 68,8% asistió a clases de preparación para el parto. El 61,4% refirió haber buscado consejos sobre cuidados del recién nacido, mayoritariamente en internet y libros. El 74,4% consideró suficiente la información recibida. Los aspectos de información más demandados fueron lactancia materna (33,3%), artificial (20,0%) y cuidados del cordón umbilical (11,1%). Las madres que demandaron más información acudieron con más frecuencia a clases de preparación para el parto (significativo) y buscaron información durante la gestación (no significativo). Asimismo, este grupo otorgó significativamente peores puntuaciones a la facilidad para plantear dudas y el grado de confianza en el pediatra. Conclusiones. La satisfacción de las madres respecto a la información ofrecida es buena; la mayoría no demanda más información. El aspecto sobre el que con más frecuencia demandan más información es la lactancia. La demanda de información es independiente de la edad materna, los estudios maternos, la situación laboral o la existencia de hijos previos. Asimismo, las dudas que les surgen a las madres no se ven satisfechas únicamente por la asistencia a clases de preparación para el parto.

Introduction.It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. Population and Methods.Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. Results.A hundred and seventy-six surveys were collected. Of these, 68.8% respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3%), bottle feeding (20.0%), and umbilical cord care (11.1%). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. Conclusions.Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.

Valoración de las madres acerca de las recomendaciones para el cuidado del recién nacido al momento del alta hospitalaria / Maternal assessment of recommendations on the newborn infant care upon hospital discharge

Introducción. Es habitual que el pediatra ofrezca a los padres información sobre cuidados del neonato al momento del alta hospitalaria. Los objetivos del estudio son conocer la satisfacción respecto a dicha información, qué otras informaciones les hubiese gustado recibir y determinar qué factores pueden influir en esa demanda. Población y métodos. Estudio descriptivo que evalúa la opinión de las puérperas a los 5-15 días del parto, en cuanto a dicha información. Resultados. Se recogieron 176 encuestas. El 68,8% asistió a clases de preparación para el parto. El 61,4% refirió haber buscado consejos sobre cuidados del recién nacido, mayoritariamente en internet y libros. El 74,4% consideró suficiente la información recibida. Los aspectos de información más demandados fueron lactancia materna (33,3%), artificial (20,0%) y cuidados del cordón umbilical (11,1%). Las madres que demandaron más información acudieron con más frecuencia a clases de preparación para el parto (significativo) y buscaron información durante la gestación (no significativo). Asimismo, este grupo otorgó significativamente peores puntuaciones a la facilidad para plantear dudas y el grado de confianza en el pediatra. Conclusiones. La satisfacción de las madres respecto a la información ofrecida es buena; la mayoría no demanda más información. El aspecto sobre el que con más frecuencia demandan más información es la lactancia. La demanda de información es independiente de la edad materna, los estudios maternos, la situación laboral o la existencia de hijos previos. Asimismo, las dudas que les surgen a las madres no se ven satisfechas únicamente por la asistencia a clases de preparación para el parto.(AU)

Introduction.It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. Population and Methods.Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. Results.A hundred and seventy-six surveys were collected. Of these, 68.8% respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3%), bottle feeding (20.0%), and umbilical cord care (11.1%). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. Conclusions.Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.(AU)

Valoración de las madres acerca de las recomendaciones para el cuidado del recién nacido al momento del alta hospitalaria / Maternal assessment of recommendations on the newborn infant care upon hospital discharge

Introducción. Es habitual que el pediatra ofrezca a los padres información sobre cuidados del neonato al momento del alta hospitalaria. Los objetivos del estudio son conocer la satisfacción respecto a dicha información, qué otras informaciones les hubiese gustado recibir y determinar qué factores pueden influir en esa demanda. Población y métodos. Estudio descriptivo que evalúa la opinión de las puérperas a los 5-15 días del parto, en cuanto a dicha información. Resultados. Se recogieron 176 encuestas. El 68,8% asistió a clases de preparación para el parto. El 61,4% refirió haber buscado consejos sobre cuidados del recién nacido, mayoritariamente en internet y libros. El 74,4% consideró suficiente la información recibida. Los aspectos de información más demandados fueron lactancia materna (33,3%), artificial (20,0%) y cuidados del cordón umbilical (11,1%). Las madres que demandaron más información acudieron con más frecuencia a clases de preparación para el parto (significativo) y buscaron información durante la gestación (no significativo). Asimismo, este grupo otorgó significativamente peores puntuaciones a la facilidad para plantear dudas y el grado de confianza en el pediatra. Conclusiones. La satisfacción de las madres respecto a la información ofrecida es buena; la mayoría no demanda más información. El aspecto sobre el que con más frecuencia demandan más información es la lactancia. La demanda de información es independiente de la edad materna, los estudios maternos, la situación laboral o la existencia de hijos previos. Asimismo, las dudas que les surgen a las madres no se ven satisfechas únicamente por la asistencia a clases de preparación para el parto.(AU)

Introduction.It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. Population and Methods.Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. Results.A hundred and seventy-six surveys were collected. Of these, 68.8% respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3%), bottle feeding (20.0%), and umbilical cord care (11.1%). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. Conclusions.Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.(AU)

Maternal assessment of recommendations on the newborn infant care upon hospital discharge. / Maternal assessment of recommendations on the newborn infant care upon hospital discharge.

INTRODUCTION: It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. POPULATION AND METHODS: Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. RESULTS: A hundred and seventy-six surveys were collected. Of these, 68.8

respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3

), bottle feeding (20.0

), and umbilical cord care (11.1

). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. CONCLUSIONS: Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.

Neonatal screening for congenital adrenal hyperplasia: transitory elevation of 17-hydroxyprogesterone.

AIM: The aim of the study was to identify patients with transitory elevation (TE) of 17-hydroxyprogesterone (17-OHP) using neonatal screening for congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21-OHD) and to compare them with patients with 21-OHD. METHODS: This was a retrospective study of patients with high 17-OHP levels detected during newborn screening in Madrid, Spain. RESULTS: 17-OHP levels were significantly higher in the 33 21-OHD patients, who tended to present hyponatraemia and hyperkalemia. The TE-17-OHP group was characterized by normal initial physical examination (88.8% vs. 39.4%), lower gestational age and a higher number of stressful perinatal factors. 17-OHP levels decreased spontaneously in this group. Molecular diagnosis allowed us to discard the most frequent mutations associated with 21-OHD. CONCLUSIONS: Newborns with slightly increased 17-OHP levels and normal results for physical examination, acid-base equilibrium, glycemia, electrolytes and perinatal stress factors should be carefully evaluated. Decisions on treatment should be postponed until these results are available.